To think that pre admission screening should include bloods?

[EachandEveryone]

Im so stressed trying to get organised for my hysterectomy. Ive never had surgery before and its two weeks today. I went for my preassessment today and at the end of it i asked the nurse if she was taking any bloods and she said no as id had them taken three weeks ago when i was rushed in. Thats fine. Then she gave me a blood form and told me to make an appointment to get my blood taken so they could group it. They cant do the op withput it so she said.

Ok. So the three hospitals in my trust dont have any appointments to take my blood til after the op. The walk in clinic is miles away and will cost 23£ each way in a cab. Plus i work full time its just not possible.

Its very fortunate that i am a nurse and will beable to get a colleague to do it but what if i wasnt? Are people expected to chase around all over the shop for a simple blood group test? What if my blood gets lost becase ive gone through the back door?

Im sorry for venting but its such a simple thing that surely shouldve been done today?

I don't understand - if you are a nurse surely you would know this or be able to find out. I've never heard of a trust making appointments for routine bloods, I thought you just turned up and waited your turn..

If your surgery is two weeks away then any blood taken at preadmission for group & screen would have expired by the time you were admitted - am surprised you don’t know that. Most group & screen samples are valid for 5 days only.

We give all our patients their forms and tell them to get it taken 2 days preop. They can get it taken either by the hospital phlebotomy service or the GP; the hospital service you just turn up, take a number and wait. No appointment needed.

Yes but aren’t all trusts different? Believe me I’ve tried to get an appointment there are none.

I’ve never had surgery before. I will go into work on my day off. And yes I’m shocked it’s not a walk in service. I’m remenvering fondly the days when the practice nurse at the gps would do it.

Surely you know whatnyour Trust does?

HicDraconis can your blood group change in a few weeks?

Did they not type your blood when you were rushed in a few weeks ago?

The trusts I've been a patient in the last couple of decades have operated a 'rock up at any time with your bag of test tubes and referral letter' policy.

Wow mine don’t unfortunately

Group and save is only valid for 72 hours where I work. Your blood group is very unlikely to change (very rare chance your rhs status could) but it's because of potential antibody development.

Our hospital do bloods at drop in blood clinic the day before.

In my area you turn up at any of the clinics, take a ticket and wait your turn. The only time you need an appointment if your GP does them but I've learnt just go to.the same hospital as then the blood results can be shared across departments and your GP.

Ok. Ive got an appointment in my local hospital two days before.

I need someone to answer this. She said she has to make it clear to me that the group and save im having done is not at the hospital im having the operation at and even though they are the same trust they cant be responsible if anything happens and the blood isnt there. Can someone clarify what that means? She actually couldn't get me an appointment where im having my surgery anyway and im thrilled ive got one at my local hospital.

Why might this be a problem? Im not a nurse on the general side and we do thngs very differently.

Why might this be a problem? Im not a nurse on the general side and we do thngs very differently.
If you work there and you don't know how it works, then how are the public supposed to know how it works? It's no wonder people turn up at A&E inappropriately and all the NHS does is whinge about it

Group and saves are only usually valid for a maximum of 7 days. If you are a nurse then you should know that giving blood transfusions is not a risk free procedure even if the blood is O negative. There are numerous different blood groups in the human body aside from ABO and positive/negative. It is possible for a person to produce antibodies against any blood group which could result in severe reactions if the wrong blood is given. You can't rely on a group and save from months ago because there's a chance you might have developed an important antibody inbetween then and now. 7 days is given as the maximum period of time considered safe to work on a historic group and save for, some trusts will not even allow up to 7 days and may have a blanket rule of 5 or 3 days for instance. For patients with known histories of producing antibodies to other blood groups they will only ever be given a 3 day window for the rest of their lives as they are considered high risk for developing new antibodies. It is also a requirement in most trusts that a patient has at least 2 group and screens done independently of each other before any blood transfusions happen. This is to double check that we have gotten the patients blood group correct as nurses can and do put the wrong patients blood in tubes which can, and has, caused significant injury and death in the past to the patient.

Trusts don't make these rules up for the hell of it, they do it because blood transfusions can be extremely dangerous if done wrong. This is why you have scientists working in labs with years of expertise ensuring patients get given the right blood. If you left choosing compatible blood up to nurses and doctors there would be hundreds of deaths and serious injury every year from incompatible transfusions. Unless you are a haematologist there isn't the need for nurses and doctors to understand this stuff, they just have to take in faith that the scientists have done their bit correctly.

It's pretty piss poor they can't offer you an appointment to get your bloods done before your operation though, the trust I work in has no issues getting majority of patients bled beforehand. In rare cases a patient may have to be bled the morning of the operation but assuming they have no complicated antibodies it should only take 1 hour from receipt of the samples in the lab to have blood available, so if they bleed the patient as soon as they arrive at the hospital we can make sure they have blood available before the operation starts.

Hope that helps a bit.

So do you think its a problem getting it done in my local hospital which is the same trust but about an hours drive away? The person who booked it said she had to make me aware that i was getting it done in a differebt place.

To the person who saud im a nurse i should know this stuff why would i when i dont encounter it ever?

To the person who saud im a nurse i should know this stuff why would i when i dont encounter it ever?
Not being funny, but with that attitude should you be a nurse?

Whether you should get it done at the local hospital depends if they share an online blood reporting system. The trust I work at I believe does, so it wouldn’t matter if blood was taken at hospital A or B as they’re in the same trust with same computer system and results would be available. You need to find that out.

Thanks. Its the same trust and the nurse today never mentioned it she just said to get an appointment at any of the three hospitals.

You need to check - where I work there are three hospitals within the trust where you can have surgery. Only two of them have their own blood bank. If you’re having surgery in either of those you must have the sample processed in that lab (it can be taken in the other major hospital but has to be sent in a taxi to be processed at the other site) - if you’re having surgery at the hospital without a blood bank you have to go to a specific hospital to have your blood taken. Most places I’ve worked will not accept group and save samples from other hospitals within the trust.

Oh and ours share a computer system, so all other bloods it doesn’t matter where they are taken, it’s just for group and save.

I just don’t know if some trusts have different systems for different hospitals and don’t share results. I wouldn’t have thought so but it’s possible.

The trust I work at I believe does, so it wouldn’t matter if blood was taken at hospital A or B as they’re in the same trust with same computer system and results would be available.

This happens at the trust where I'm training as well.

I know having a hysterectomy is very very stressful, and I'm sorry that you're having to do all of this, it shouldn't be like this at all.

I suggest that you call the pre-op team tomorrow and let them know where you're having your bloods done and clarify that they will be able to see the results.

Also please give some feedback via your consultant or your GP about this so hopefully they will look into it and change it for future patients.

Good luck with your operation

When having fertility tests last year I needed blood tests done on certain days of my menstrual cycle.
My GP surgery had no blood test service for 3 weeks due to annual leave and told me to ring local hospital. The earliest appointment they offered was 6 weeks away unless for diabetes or warfarin.
I had to ring 4 times and on the 4th attempt spoke to someone sympathetic who actually booked me in.
For further blood tests I used a private service.

You need to know whether the hospitals within your trust share the same computer system. If you have your blood taken at one hospital and they don't share the same reporting system, then your results won't be available for the other hospital to view.

I would take the blood form and get a colleague to take my blood and then take the samples and the blood form to the lab at the referring hospital, tbh. Most people use vacutainer so it's likely it would be the same bottles.

It's also crap that you can't get an appointment or a walk in to get your bloods done for the procedure.

We use phlebs at the local Asda. It's brilliant. All goes to the hospital lab but you can be in and out in 5 mins.

It does say on the form she gave me use any of the three hospitals. Its just when i called to make the appointment the booker said it was now policy to inform people that the blood clinic is not the same as where my surgery is and if anything happened it could be a problem.